Joseph Corbin Prestidge, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.200633 Issued in LA

Practice address

18540 White Oak Dr
Prairieville, LA 70769-3737

Phone

(225) 802-8030

NPI assigned

Jun 12, 2013

Last updated

Jul 1, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lake Urgent Care Ascension LLC

  dba Lake Urgent Care - Ascension

  • Urgent Care Clinic/Center
  • Prairieville, LA
  • NPI 1912243122
  Medicare reassignment NPD
• South Louisiana Medical Associates

  • Surgery Physician
  • Houma, LA
  • NPI 1942301379
  Medicare reassignment
• South Louisiana Medical Associates

  • Durable Medical Equipment & Medical Supplies
  • Houma, LA
  • NPI 1699218131
  NPD
• South Louisiana Medical Associates

  • Internal Medicine Physician
  • Houma, LA
  • NPI 1710944012

  Physician Assistant

  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1194163121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18540 WHITE OAK DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693737",
            "telephone_number": "225-802-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18540 WHITE OAK DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693737",
            "telephone_number": "225-802-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIDGE",
        "first_name": "JOSEPH",
        "middle_name": "CORBIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-12",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prairieville General Hospital, LLC (Prairieville Family Hospital)
• Prairieville General Hospital, LLC
• Prairieville Pharmacy LLC (Prairieville Pharmacy)
• Premier Health & Wellness Group, LLC
• Premier South Rehabilitation Services, LLC
• Prestige Dentistry, LLC
• Hayden Scott Price
• Caprielle Grace Priola, M.A., CF-SLP
• Psychological Wellness & Consulting
• Pt2Go, LLC

• Physician Assistant in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.